Pipelle biopsy Whakamātaunga kiri kōpū

A pipelle biopsy is a procedure that takes a small sample (biopsy) of cells from the lining (endometrium) of your uterus. The sample is sent to a laboratory to look for any abnormal cells.

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When you would have a pipelle biopsy

You might be advised to have a pipelle biopsy for a number of reasons: 

  • if you start having your periods or some bleeding when you have already gone through menopause
    Menopause
  • if you have very heavy period bleeding, or bleed between your periods
  • if you bleed after sex
  • if a cervical screen showed any uterine lining (endometrial) cells
  • if you had an ultrasound of your pelvis and it showed a thick lining of your uterus (endometrium).

Having a pipelle biopsy

A pipelle biopsy is usually done by your healthcare provider. If they do not do this procedure, they will refer you to another healthcare provider who does. They will let that team know about the reason for your biopsy and send the results of any previous tests you had done. Your healthcare provider will discuss this with you.

You should not have this procedure if you:

  • are pregnant
  • are at risk of being pregnant (you are not using reliable contraception)
  • have a bleeding disorder
  • have pelvic pain or discharge
  • are unwell with a fever (high temperature) on the planned day of the procedure
  • have pelvic inflammatory disease.

Tell your healthcare provider if you have or develop any of these conditions.

If your healthcare provider says you need a pipelle biopsy, you should have it within a few weeks of it being requested. If you do not get an appointment or cannot attend the appointment, contact your healthcare provider.

Before your pipelle biopsy

You do not need to do anything to prepare for your biopsy. You might experience period-like pain for a few hours after the procedure.

To help prevent this, you can take simple pain relief such as an anti-inflammatory pain relief tablet 1 to 2 hours before your appointment. If you cannot safely take anti-inflammatory medicines, take paracetamol instead.

Pain relief medicines for adults

Talk to your healthcare provider or pharmacist about what pain relief medicine is safe for you.

Take a sanitary pad with you to use after the procedure.

Arrange to have someone you can call to come and collect you after the procedure. You may not feel able to drive home safely afterwards.

During your pipelle biopsy

At your appointment for pipelle biopsy you will be asked to undress fully or from the waist down. You will be given a hospital gown or robe to put on. Then you will need to lie down on an examination table.

The healthcare provider will check the size and position of your uterus. They will gently put 2 fingers in your vagina, then place their other hand on the lower part of your tummy (abdomen).

The healthcare provider will insert a speculum into your vagina. A speculum is an instrument used to hold open the vagina. They may also use an instrument that helps hold your cervix in the best position to take the sample.

The healthcare provider will then insert the pipelle through your cervix into your womb. The pipelle is a thin, plastic tube similar to a straw. To take the sample, they will pull the pipelle, which creates a slight suction. You may feel some cramping at this time.

They will then remove the speculum and send the sample to the laboratory.

Your pipelle biopsy results

Your healthcare provider will get a copy of your test results about one week after your procedure was done. Contact them if you are not told the test results within 2 weeks.

If you have any problems that need further help, contact your healthcare provider. Go to an after-hours service if your usual healthcare provider is closed.

After your pipelle biopsy

You will not need time off work. You can carry out all your normal activities, including exercise, if you feel able to.

It is common to have a small amount of bleeding for a few days afterwards. You should use sanitary pads during this time, not tampons.

Do not have sex for 48 hours after the procedure.

There is a very small risk of pelvic infection. Contact your healthcare provider if you are still getting any pelvic pain or cramping more than 48 hours after the procedure or if you develop a fever.

Risks of pipelle biopsy

The procedure is usually very safe. You may:

  • feel some period-like pain
  • rarely, have prolonged bleeding or infection.

Very rarely, the procedure could make a hole in your uterus (uterine perforation). This can be serious and you:

  • might need to see a specialist at the hospital 
  • may need to have surgery to repair the hole.

Healthcare services may be provided to you only if you make an informed choice and give informed consent to it. This forms part of your rights (Rights 5, 6 and 7) under the Code of Health and Disability Services Consumer Rights (the Code).

The Code and Your Rights/Ōu Mōtika — Health & Disability Commissioner

The 3 rights that together allow for informed consent are:

  • Right 5 — the right to effective communication
  • Right 6 — the right to be informed
  • Right 7 — the right to choice and consent.

This means you must be told about the service being suggested, including any risks or possible complications. You must have the chance to ask as many questions as you need to understand the information you are given.

You also have the right to have someone with you to help you. But the decision to say 'yes' or 'no' must be yours (unless you are unable to make that decision due to illness or other impairment, or sometimes in an emergency).

You also have the right to be given the information in a language you fully understand. You can ask for an interpreter if you need one.